PURPOSE: Current evidence indicates that ultrasonography of the breast is an important adjunct to mammography and clinical examination in the diagnosis of palpable breast abnormalities. An assessment of the value of office-based ultrasonography of a palpable breast mass performed by a breast surgeon was the aim of this work. METHODS: A 7.5 MHz linear probe was used to perform office-based ultrasonography in 109 consecutive female patients having a palpable solid breast mass between August 1998 and December 1999. Breast masses diagnosed histologically as fibroadenomas or breast cancer were included in this study. The clinical impression from the physical examination (PE), the result of officed-based ultrasonography done by a surgeon (OUSG), and comprehensive judgement engaging both PE and OUSG (PEUSG) were recorded in each patient's hospital record as benign or malignant at the first visit. The diagnostic values of PE, OUSG, PEUSG, mammography (MMG), and ultrasonography done by a radiologist (USG) were compared. RESULTS: Of 109 masses, a fibroadenoma was diagnosed in 73 patients while a carcinoma was established in 36 patients. The sensitivity, the specificity, the accuracy rate, and the kappa coefficient were 91.7%, 89.0%, 89.9%, and 0.780 for PE; 100%, 90.4%, 93.6%, and 0.862 for OUSG; 97.2%, 97.3%, 97.2%, and 0.938 for PEUSG; 90.4%, 89.4%, 90%, and 0.630 for MMG; and 88.9%, 90.9%, 90% and 0.798 for USG. The diagnostic accuracy of PEUSG was significantly higher than those of PE and MG (p<0.05). CONCLUSION: These data suggest that office-based ultrasonography of the breast performed by a surgeon is a useful adjunct to clinical evaluation of the breast mass and permits timely and cost-effective patient care.
Breast Neoplasms ; Breast* ; Diagnosis* ; Female ; Fibroadenoma ; Hospital Records ; Humans ; Mammography ; Patient Care ; Physical Examination ; Prospective Studies* ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: The cross-protection of 7-valent pneumococcal conjugate vaccine (PCV7) against vaccine-related serotypes has been controversial. We investigated the serological properties of cross-protective antibodies against vaccine-related serotypes 6A, 6C, and 19A induced in young children aged 12-23 months after booster immunization of PCV7. METHODS: IgG and IgM antibody concentrations and opsonic index (OI) against vaccine serotypes 6B and 19F and vaccine-related serotypes 6A, 6C, and 19A were measured by ELISA and opsonophagocytic killing assay (OPA) in 4 selected immunesera. The serological properties and antigenic specificity of protective antibodies were determined by IgM depletion of immunesera, OPA, and competitive OPA against serogroup 6 and 19 pneumococci. RESULTS: Compared to pre-IgM depleted immunesera, OI of IgM-depleted immunesera against 6B and 19F decreased and OI against 6A, 6C, and 19A decreased, too. In competition OPA, free 6B and 19F polysaccharide completely inhibited the immune protection against vaccine-related serotypes 6A, 6C, and 19A as well as vaccine types 6B and 19F. CONCLUSIONS: The booster immunization of PCV7 certainly induced cross-protective antibodies against vaccine-related serotypes 6A, 6C, and 19A with both IgG and IgM isotypes. Furthermore, IgM antibodies are more highly contributed to opsonophagocytic activity against vaccine-related serotypes as well as most of vaccine types than do IgG antibodies. Further studies are needed for the more immunized sera in the children as well as adults.
Adult ; Aged ; Antibodies ; Child ; Cross Protection ; Enzyme-Linked Immunosorbent Assay ; Epitopes ; Homicide ; Humans ; Immunization ; Immunization, Secondary ; Immunoglobulin G ; Immunoglobulin M ; Pneumococcal Vaccines ; Streptococcus pneumoniae ; Heptavalent Pneumococcal Conjugate Vaccine

BACKGROUND: Hypothyroidism may be involved in a significant portion of the causes of hypercholesterolemia in Korea. In this study, we determined the frequency of suspected hypothyroidism in hypercholesterolemic patients and compared the frequency of elevated thyrotropin levels among the groups with various total cholesterol levels. METHODS: The study subjects were healthy, asymptomatic people who visited Health Promotion Center of Seoul National University Hospital. We excluded subjects with history of hypertension, DM and hypothyroidism. The study subjects underwent physical examination and filled out a questionnaire on health risk factors. Also blood chemistry and thyroid function test were done. RESULTS: Among 6479 subjects, 194(2.99%) had elevated(>4.1 microIU/ml) thyrotropin levels. Among the hypercholesterolemic(> or=240mg/dl) patients(n=868), 40(4.60%) had elevated thyrotropin levels. And there was statistically significant difference between normal cholesterolemic and hypercholesterolemic subjects(P<0.05). Among the patients with total cholesterol above 280mg/dl (n=180), 15(8.33%) had elevated thyrotropin levels. As amount of the total cholesterol increased, the frequency of elevated thyrotropin levels Increased(P=0.001). And this result was consistent following adjustment for age, sex, BMI, smoking and drinking status(P<0.01). CONCLUSIONS: Practicing physicians should be aware of the possibility of secondary hypercholesterolemia due to hypothyroidism and keep in mind the importance of evaluating TSH level.
Chemistry ; Cholesterol* ; Drinking ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Hypothyroidism ; Korea ; Physical Examination ; Risk Factors ; Seoul ; Smoke ; Smoking ; Thyroid Function Tests ; Thyrotropin* ; Surveys and Questionnaires

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

To evaluate the potential contribution of high resolution ultrasonography(US) and 99mTc scintigraphy in the routine diagnosis of thyroid nodules, we performed thyroid function tests, US, thyroid scintigraphy, and fine-needle aspiration cytology (FNAC) in all 54 patients who initially visit our surgical department for thyroid masses from March 1995 to February 1996. The final diagnoses were made by either repeated FNAC (n=39) or thyroid operations (n=15). Final diagnoses were adenomatous goiters (n=41), simple cysts (n=3), follicular adenoma (n=1), papillary carcinomas (n=8), follicular carcinoma(n=1). The diagnostic impacts of US and 99mTc scintigraphy in all 54 patients were assessed and scored according to the following criteria: when the information provided by either test supported or confirmed (and/or gave some other information for management of thyroid nodules) the final diagnosis, it received a scores of 2 or 3 respectively, while a score 1 was given when the test itself was useless for the differential diagnosis. The scores of US were higher than those of scintigraphy in the diagnoses of adenomatous goiters, cysts, adenomas and carcinomas. However, after statistical analysis with Wilcoxon's signed rank test, US was statistically superior to scintigraphy only in diagnosing adenomatous goiters. These results indicate that current findings in US for differential diagnosis of thyroid nodules are not absolutely superior to those in scintigraphy, but have some benefits in detection of occult nodules in malignancy and differential diagnosis of adenomatous goiters.
Adenoma ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential ; Goiter ; Humans ; Radionuclide Imaging* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Nodule*

No abstract available.
Child* ; Heart Neoplasms* ; Humans

STATEMENT OF PROBLEM: Many dental clinicians are concerned about immediate loading of inserted implants. However, there have been few clinical studies surveying the success rates of immediate loading, based on Korean implant systems. PURPOSE: The aim of this study was to evaluate the outcome of immediate functional loading of the implant (SinusQuick(TM) EB, Neobiotech Co., Seoul, Korea) in partially edentulous maxilla or mandible. MATERIAL AND METHODS: Total 15 implants were placed. Within 2 weeks after implant insertion, provisional implant-supported fixed partial dentures were delivered to the patients. Quantitatively, marginal bone loss was measured at the time of immediate loading, after 3-months of continued loading and at the last follow-up. The mean follow-up period was 4.8 months. RESULTS: Mean marginal bone loss from implant surgery to early loading, 3-months follow-up and last follow-up was 0.03 +/- 0.07 mm, 0.16 +/- 0.17 mm and 0.29 +/- 0.19 mm. No implant failed up to 6 months after insertion, resulting in a 100% survival rate. CONCLUSION: Immediate loading exhibited high success rate in partial edentulism for up to 6 months. Well-controlled long term clinical studies with large sample size are necessary to confirm this finding.
Dental Implants ; Denture, Partial, Fixed ; Follow-Up Studies ; Humans ; Mandible ; Maxilla ; Prospective Studies ; Sample Size ; Survival Rate

Pulmonary aspergillosis is classified as a saprophytic, allergic, and invasive disease. Chronic necrotizing pulmonary aspergillosis is categorized as an invasive pulmonary aspergillosis. Most invasive pulmonary aspergillosis have acute and toxic clinical features but chronic necrotizing pulmonary aspergillosis is characterized by a sub-acute infection, most commonly seen in patients with altered local defense system from preexisting pulmonary disease of in mild immunocompromised patients. Pulmonary artery aneurysm due to this infection is termed as a mycotic aneurysm, etiology of which are tuberculosis, syphilis, bacteria and fungus. We report a case chronic necrotizing pulmonary aspergillosis complicating pulmonary aneurysm is a 62 year-old man who was presented with cough, sputum, and fever. Chest radiographs showed a rapid, progressive cavitary lesion and pulmonary artery aneurysm. Angioinvastion of aspergillus was revealed by pathology after operative removal of left upper lobe containing the pulmonary artery aneurysm. He was treated with itraconazole.
Aneurysm* ; Aneurysm, Infected ; Aspergillus ; Bacteria ; Cough ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis* ; Itraconazole ; Lung Diseases ; Pathology ; Pulmonary Artery* ; Pulmonary Aspergillosis ; Radiography, Thoracic ; Sputum ; Syphilis ; Tuberculosis

BACKGROUND: In order to improve the quality of life of dying patients so that they may die with dignity, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care. However, their is no adequate medical service at present. We studied terminal cancer patients'behavior patterns of health care utilization, the problems of caring for the patient, and medical services that bereaved families suggested for terminal cancer patients and their families. METHODS: From 271 patients'families who participated in our hospice program from March 1991 to February 1996, 108 bereaved families whom we able to had been contact were interviewed by three student nurses with a structured questionnaire. RESULTS: The terminal cancer patients received their medical care through admission to hospital(45.4%), outpatient clinic(22.2%), emergency room(16.7%), and oriental medicine(12.0%). But during their terminal phase of the illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative medicine care such as intake of mushroom and elm tree. 26 bereaved families(24.1%) pointed out the indifference of the medical team as a problem receiving proper hospital care, and 22 bereaved families(20.4%) emphasized emotional strain of their helplessness with the patient's suffering as a problem of caring for the patient at home. Over 90% of bereaved families from their experience suggested needs of continuous care, hospice care, home care, and 24hr telephone service. CONCLUSIONS: There were inappropriate behavior patterns of health care utilization which resulted in large proportion of terminal cancer patients received alternative medicine never receiving proper medical care. Therefore, there is a need to develop the continuous and comprehensive care for terminal cancer patients and their family, such as hospice.)
Agaricales ; Complementary Therapies ; Delivery of Health Care* ; Emergencies ; Home Care Services ; Hospice Care ; Hospices ; Humans ; Medicine, East Asian Traditional ; Outpatients ; Quality of Life ; Telephone ; Ulmus ; Surveys and Questionnaires

The purpose of this study was to provide basic data on elementary school children's lifestyle and to contribute to developing on the health education program in elementary schools. The subjects were 1,412 children in 4 elementary schools in Gangwon-Do and Chonrabuk-Do area. Data collection was done from September to November 2001 by questionnaire and school health documents. The questionnaire corrected for the purpose of this study which had been developed by Bronson School of Nursing(1991), 'Lifestyle Questionnaire for School-age Children'. The questionnaire consists of 3 categories; 'Activities that promote health', 'Injury prevention', 'Feeling'. Cronbach coefficient alpha for the 29 items was .68. The data analyzed to obtain frequency, mean, percentage, t-test, ANOVA and Pearson correlation coefficient by SPSS Win program. The results of this study were as follows. 1. Females(50.2%) of gender, 6th grade(24.2%) of grade, nuclear family(82.0%) of family type, beyond college graduate(54.5%) of father's school career, under high school graduate(58.1%) of mother's school career, first of birth order(47.1%) were majority. Mean of father's age was 41.2 and mother's age was 38.1. 2. The mean of lifestyle was 66.4, feeling was 73.3, activities that promote health was 60.3 and injury prevention was 64.0. The highest degree of activities that promote health was "I eat fruits" and injury prevention was "I look both ways when crossing streets"and feeling was "I enjoy my family". The lowest degree of activities that promote health was "I visit the dentist every tear" and injury prevention was "I wear a helmet when I go on bike trips" and feeling was "I think it is okay to cry". 3. There were significant differences in lifestyle of gender(t=4.309, p=.000), grade(F=6.299, p=.000), father's age(t=2.534, p=.011), father's education(t=-4.933, p=.000), mother's education(t=-3.360, p=.001), birth order (t=5.363, p=.000). There were significant differences in activities that promote health of gender(t=-2.462, P=.014), grade(F=4.893, p=.000), father's education(t=-4.480, p=.000), birth order(t=4.343, p=.000), in injury prevention of gender(t=-4.452, p=.000), grade(F=8.636, p=.000), father's age(t=3.386, p=.001), mother's age(t=2.059, p=.040), father's education(t=-6.051, p=.000), mother's education(t=-5.173, p=.000), birth order(t= 4.417, p=.000) and in feeling of gender (t=-3.285, p=.001), grade(F=7.526, p=.000), mother's age(t=-3.268, p=.001). 4. Activities that promote health was positively correlated with injury prevention(r=.432, p=.000), feeling(r=.210, p=.000), lifestyle (r=.785, p=.000). Injury prevention was positively correlated with feeling(r=.256, p=.000), lifestyle(r=.854, p=.000) also feeling was positively correlated with lifestyle(r=.504, p=.000). These findings suggest the need to develop nursing strategy to promote elementary school children's health. Because helmet use score in injury prevention marked the lowest score, it is necessary to encourage helmet use when planning injury prevention and health promotion.
Birth Order ; Child ; Data Collection ; Dentists ; Gangwon-do ; Head Protective Devices ; Health Education ; Health Promotion ; Humans ; Life Style* ; Nursing ; Parturition ; School Health Services ; Child Health ; Surveys and Questionnaires